Multinational comparison study of aircraft pilot healthcare avoidance behaviour

W R Hoffman; P K Patel; J Aden; A Willis; J P Acker; E Bjerke; E Miranda; J Luster; A Tvaryanas

doi:10.1093/occmed/kqad091

Multinational comparison study of aircraft pilot healthcare avoidance behaviour

Occup Med (Lond). 2023 Oct 20;73(7):434-438. doi: 10.1093/occmed/kqad091.

Authors

W R Hoffman^{1

2}, P K Patel³, J Aden⁴, A Willis¹, J P Acker^{5

6}, E Bjerke², E Miranda¹, J Luster¹, A Tvaryanas⁷

Affiliations

¹ Department of Neurology, Brooke Army Medical Center, Fort Sam Houston, TX, 78234USA.
² Department of Aerospace Science, University of North Dakota, Grand Forks, ND, 58202USA.
³ Cumming School of Medicine, University of Calgary, Calgary, Alberta, T2N 4N1Canada.
⁴ Department of Graduate Medical Education, Brooke Army Medical Center, Fort Sam Houston, TX, 78234USA.
⁵ Department of Laboratory Medicine and Pathology, University of Alberta, Edmonton, Alberta, T6G 2R3Canada.
⁶ Innovation and Portfolio Management, Canadian Blood Services, Edmonton, AB, T6G 2R8Canada.
⁷ Civil Aerospace Medical Institute, Federal Aviation Administration, Oklahoma City, OK, 73169USA.

PMID: 37658781
DOI: 10.1093/occmed/kqad091

Abstract

Background: US and Canadian pilots are required to meet medical standards to secure their active flying status, but a subgroup exhibit healthcare avoidance behaviour due to fear of loss of that status. This phenomenon has the potential to impact pilot health, aeromedical screening and aviation safety. No international comparison study of pilot healthcare avoidance currently exists between US and Canadian pilots.

Aims: To compare the rate and subtypes of healthcare avoidance behaviour secondary to fear for loss of flying status between US and Canadian pilots.

Methods: A comparison analysis of data collected during two independent, non-probabilistic, cross-sectional internet surveys including any individual certified to perform flying duties in the USA (US survey) or Canada (Canadian survey).

Results: There were 4320 US pilots and 1415 Canadian pilots who completed informed consent and 3765 US pilots and 1405 Canadian pilots were included in the results. There were 56% of US pilots who reported a history of healthcare avoidance behaviour compared to 55% of Canadian pilots (P = 0.578). A multivariable logistic regression that included age, pilot type and gender showed that US pilots were slightly more likely than Canadian pilots to report this behaviour (odds ratio 1.22, 95% confidence interval 1.06-1.4).

Conclusions: Healthcare avoidance behaviour due to fear of loss of flying status has a relatively high prevalence in both US and Canadian pilot populations.